I am doing a little research to help my mother with her current health situation. I am seeking interpretation and possibly advice.
Mother, aged 84 and having suffered from a significant repiratory ailment a little over a year ago, was referred for diagnostic imaging. CT scan revealed numerous bilateral ground glass opacities (GGOs). Surveillance every 3 months suggested some growth in two of the larger nodules, both remain <5mm. Follow up was PET scan which showed some moderate FDG uptake in opacities with none identified as being primary. An unexpected result showed significant mediastinal lymph node and hilar lymph node uptake. Additional update was evident in parotid, identified as probable benign Warthin's tumor. Subsequent meeting with thoracic surgeon concluded with recommendation for further surveillance.
Medical history includes ongoing issues with irritable bowel syndrome (IBS), the onset of which was approximately a decade ago. In her youth, her roommate was taken to a sanitorium due to tuberculosis. She has some high blood pressure, but is otherwise unremarkable except for a recent history of skin cancer. Skin cancers included several basal cell carcinomas, treated by cryogenic and surgical removal, and a single squamous cell carcinoma, treeated with surgical removal and radiation. History of smoking (pack/day) from age 14-70. She has been a non-smoker for approximately 15 years. Currently asymptomatic except perhaps weakening of voice which may simply be age related. Also showing some minor nail clubbing.
At 84 years old, the doctor suggested no further action except to monitor the GGOs. Bronchoscopy or biopsy were ruled out as they would introduce unneccesary risk (a malignancy would necessitate chemotherapy but she is not a candidate due to age and the bilateral nature limits the viability of surgical resection).
1. Possible benign causes?
2. Additional diagnostics?
3. Probable diagnosis?
4. Recommended actions?